Reliability in headache diagnosis

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 29-33 ◽  
Author(s):  
Richard B Lipton ◽  
Walter F Stewart ◽  
Kathleen Ries Merikangas

The reliability of headache diagnosis using the criteria of the International Headache Society (IHS) has not been well studied. One definition of reliability refers to the reproducibility of diagnoses assigned to the same individual at different times. Reproducibility of diagnosis should be assessed using different clinicians at different times, with or without specific diagnostic instruments. A diagnosis may be unreliable because of variability in diagnostic criteria, in the clinical information used to assign diagnoses, or in the interpretation and application of clinical information to a given set of diagnostic criteria. Reliable diagnostic methods are essential to the development of valid diagnostic methods, as well as for the identification of headache risk factors, biological markers, and effective treatments. An approach to studying the reliability of the International Headache Society criteria is outlined, modeled after the extensive studies conducted in the area of psychiatric diagnosis.

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Caroline Gonçalves Pustiglione Campos ◽  
Aline Pacheco ◽  
Maria Dagmar da Rocha Gaspar ◽  
Guilherme Arcaro ◽  
Péricles Martim Reche ◽  
...  

ABSTRACT Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.


2017 ◽  
Vol 7 (2) ◽  
pp. 100-104
Author(s):  
M. Rożniata ◽  
K. Zujko ◽  
M.E. Zujko

The term metabolic syndrome (MetS) defines the cooccurrence of the related risk factors of metabolic origin that promote the development of cardiovascular diseases with atherosclerotic background and type 2 diabetes. The diagnostic criteria of MetS have undergone modifications for years. Until now no clear definition of MetS has been established. The latest diagnostic criteria of MetS published in 2009 by a group of IDF (International Diabetes Federation) and AHA/NHLBI (American Heart Association/ National Heart, Lung and Blood Institute) experts discern three out of five risk factors: abdominal obesity (taking into consideration population differences), elevated level of triglycerides, reduced HDL cholesterol, hypertension and fasting hyperglycemia. Genetic predispositions and environmental factors, such as lack of physical activity and improper diet are considered to be responsible for MetS development. Therefore, prevention and treatment of MetS should be based first of all on a change in modifiable lifestyle factors, among which proper diet is of essential importance.


1974 ◽  
Vol 124 (581) ◽  
pp. 359-366 ◽  
Author(s):  
Amos Welner ◽  
Jay L. Liss ◽  
Eli Robins

In a previous study (Liss, Welner and Robins, 1973), the hospital records of 212 patients who received a diagnosis of personality disorder other than antisocial personality were studied. The clinical information about these patients was used to arrive at an established psychiatric diagnosis based upon the rigorous diagnostic criteria designed for research (Feighner, Robins, Guze, Woodruff, Winokur, and Munoz, 1972). In 118 cases (56 per cent) the clinical symptoms and the course of the disorder met the required diagnostic criteria for one or more of the established psychiatric diagnoses. The remaining 94 patients (44 per cent) had too few symptoms to meet these criteria.


2021 ◽  
Vol 93 (3) ◽  
pp. 300-310
Author(s):  
Andrey A. Zaicev ◽  
Alexander I. Sinopalnikov

The article considers the issues of therapeutic management of patients with so-called difficult pneumonia, particularly, patients with diagnosed syndrome slowly resolving / nonresolving pneumonia, who do not respond to the treatment. The reasons and significant risk factors potentially affecting the effectiveness of therapy are analyzed, the therapeutic tactics of managing patients with no response to treatment are considered, the list of necessary diagnostic methods and directions of antibiotic therapy is updated. The article analyses the tactics of managing patients with pneumonia during a pandemic caused by SARS-CoV-2 coronavirus. It also provides directions of diagnostics with priority discussion of biological markers of the inflammatory response as well as antimicrobial therapy strategy.


Cephalalgia ◽  
2005 ◽  
Vol 25 (2) ◽  
pp. 117-123 ◽  
Author(s):  
F Nachit-Ouinekh ◽  
V Chrysostome ◽  
P Henry ◽  
C Sourgen ◽  
JF Dartigues ◽  
...  

Assignment of a diagnosis of migraine has been formalized in diagnostic criteria proposed by the International Headache Society. The objective of the present study is to determine the reproductibility of the formal diagnosis of migraine in a cohort of headache sufferers over a one-year period. The study was performed in a community cohort taking part in a long-term prospective health survey, the GAZEL study. Two thousand five hundred individuals reporting headache in the GAZEL cohort were sent two postal questionnaires concerning headache symptoms and features at 12-monthly intervals. Replies to the questions allowed a migraine diagnosis to be attributed retrospectively using an algorithm based on the IHS classification scheme. The response rate was 82% for the first questionnaire and 69% for both questionnaires. Of the 1733 subjects providing information at both time-points, the agreement rate for the diagnosis of strict migraine (IHS categories 1.1 or 1.2) was 77.7% (kappa = 0.48), with 62.2% of the patients with this diagnosis (IHS categories 1.1 or 1.2) at Month 0 retaining the same diagnosis at Month 12. When diagnostic criteria were widened to include IHS category 1.7 (migrainous disorder), the agreement rate of the diagnosis was similar at 77.6% (kappa = 0.52), but 82% of the patients with this diagnosis (IHS categories 1.1 or 1.2 or 1.7) at Month 0 now retained the same diagnosis at Month 12. In conclusion, the one-year reproducibility of reporting of migraine headache symptoms is only moderate, varies between symptoms, and leads to instability in the formal assignment of a migraine headache diagnosis and to diagnostic drift between headache types. This finding is compatible with the continuum model of headache, where headache attacks can vary along a severity continuum from episodic tension-type headaches to full-blown migraine attacks.


Author(s):  
S. A. Babanov ◽  
D. S. Budash

The article is devoted to the definition of occupational risk in a group of workers with high experience in dust-hazardous industries. The features of homeostasis in occupational diseases of the lungs were revealed


2020 ◽  
Vol 27 (12) ◽  
pp. 1231-1245
Author(s):  
Filippo Maffezzoni ◽  
Teresa Porcelli ◽  
Andrea Delbarba ◽  
Letizia Pezzaioli ◽  
Carlo Cappelli ◽  
...  

: Biological markers (biomarkers) play a key role in drug development, regulatory approval and clinical care of patients and are linked to clinical and surrogate outcomes. : Both acromegaly and Growth Hormone Deficiency (GHD) are pathological conditions related to important comorbidities that, in addition to having stringent diagnostic criteria, require valid markers for the definition of treatment, treatment monitoring and follow-up. GH and insulin-like growth factor-I (IGF-I) are the main biomarkers of GH action in children and adults while, in acromegaly, both GH and IGF-I are established biomarkers of disease activity. : However, although GH and IGF-I are widely validated biomarkers of GHD and acromegaly, their role is not completely exhaustive or suitable for clinical classification and follow-up. Therefore, new biological markers for acromegaly and GH replacement therapy are strongly needed. : The aim of this paper is to review and summarize the current state in the field pointing out new potential biomarkers for acromegaly and GH use/abuse.


2018 ◽  
Vol 11 (4) ◽  
pp. 87-98
Author(s):  
Abdullah Alamri

Healthcare systems have evolved to become more patient-centric. Many efforts have been made to transform paper-based patient data to automated medical information by developing electronic healthcare records (EHRs). Several international EHRs standards have been enabling healthcare interoperability and communication among a wide variety of medical centres. It is a dual-model methodology which comprises a reference information model and an archetype model. The archetype is responsible for the definition of clinical concepts which has limitations in terms of supporting complex reasoning and knowledge discovery requirements. The objective of this article is to propose a semantic-mediation architecture to support semantic interoperability among healthcare organizations. It provides an intermediate semantic layer to exploit clinical information based on richer ontological representations to create a “model of meaning” for enabling semantic mediation. The proposed model also provides secure mechanisms to allow interoperable sharing of patient data between healthcare organizations.


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